Dynamic tightrope fixation for the correction of the 1,2 intermetatarsal angle in hallux valgus surgery

Introduction Hallux valgus is a common foot deformity that causes forefoot widening, difficulty fitting shoes, bunion pain, and transfer metatarsalgia. Studies have shown that correcting the 1,2 intermetatarsal angle (IMA) can significantly reduce forefoot width and improve symptoms. This study aims...

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Main Authors: Samuel Ka-Kin Ling, Jojo Hoi-Ching Lai, Esther Man-Wai Chow, Lucci Lugee Liyeung, Arthur On-Fai Woo, Patrick Shu-Hang Yung
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Journal of Orthopaedics, Trauma and Rehabilitation
Online Access:https://doi.org/10.1177/22104917241280285
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author Samuel Ka-Kin Ling
Jojo Hoi-Ching Lai
Esther Man-Wai Chow
Lucci Lugee Liyeung
Arthur On-Fai Woo
Patrick Shu-Hang Yung
author_facet Samuel Ka-Kin Ling
Jojo Hoi-Ching Lai
Esther Man-Wai Chow
Lucci Lugee Liyeung
Arthur On-Fai Woo
Patrick Shu-Hang Yung
author_sort Samuel Ka-Kin Ling
collection DOAJ
description Introduction Hallux valgus is a common foot deformity that causes forefoot widening, difficulty fitting shoes, bunion pain, and transfer metatarsalgia. Studies have shown that correcting the 1,2 intermetatarsal angle (IMA) can significantly reduce forefoot width and improve symptoms. This study aims to review the radiological and functional outcomes of hallux valgus reconstruction with IMA closure using mini-tightrope suture buttons. Methods A case series of 52 consecutive patients who underwent minimally invasive surgical reconstruction of hallux valgus deformity utilising the dynamic tightrope fixation was included. All patients had >1 year follow-up with interim assessments at baseline, 3 months, 6 months, and 1 year. Primary outcomes included IMA in weight-bearing feet X-rays, and secondary outcomes included the hallux valgus angle (HVA) and clinical function via the Foot and Ankle Outcome Score. Results Based on radiological analysis, the 1,2 IMA and the HVA significantly improved. Clinical function also showed significant improvement in symptoms, pain, activities of daily living, and quality of life subsection. No major intra-operative complications occurred in this series; however, ∼5% of the patients required revision surgery due to a recurrence of the hallux valgus or overcorrection into hallux varus. Conclusion Dynamic tightrope fixation is a simple surgical technique that effectively corrects the 1,2 IMA during hallux valgus surgery.
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spelling doaj-art-edd583f01c3644fbbe93a26b6cadbb4f2025-08-20T03:08:18ZengSAGE PublishingJournal of Orthopaedics, Trauma and Rehabilitation2210-49252025-06-013210.1177/22104917241280285Dynamic tightrope fixation for the correction of the 1,2 intermetatarsal angle in hallux valgus surgerySamuel Ka-Kin Ling0Jojo Hoi-Ching Lai1Esther Man-Wai Chow2Lucci Lugee Liyeung3Arthur On-Fai Woo4Patrick Shu-Hang Yung5 CUHK Medical Centre, Hong Kong SAR Department of Orthopaedics and Traumatology, Faculty of Medicine, , Hong Kong SAR Department of Orthopaedics and Traumatology, Faculty of Medicine, , Hong Kong SAR Department of Orthopaedics and Traumatology, Faculty of Medicine, , Hong Kong SAR Department of Orthopaedics and Traumatology, Faculty of Medicine, , Hong Kong SAR CUHK Medical Centre, Hong Kong SARIntroduction Hallux valgus is a common foot deformity that causes forefoot widening, difficulty fitting shoes, bunion pain, and transfer metatarsalgia. Studies have shown that correcting the 1,2 intermetatarsal angle (IMA) can significantly reduce forefoot width and improve symptoms. This study aims to review the radiological and functional outcomes of hallux valgus reconstruction with IMA closure using mini-tightrope suture buttons. Methods A case series of 52 consecutive patients who underwent minimally invasive surgical reconstruction of hallux valgus deformity utilising the dynamic tightrope fixation was included. All patients had >1 year follow-up with interim assessments at baseline, 3 months, 6 months, and 1 year. Primary outcomes included IMA in weight-bearing feet X-rays, and secondary outcomes included the hallux valgus angle (HVA) and clinical function via the Foot and Ankle Outcome Score. Results Based on radiological analysis, the 1,2 IMA and the HVA significantly improved. Clinical function also showed significant improvement in symptoms, pain, activities of daily living, and quality of life subsection. No major intra-operative complications occurred in this series; however, ∼5% of the patients required revision surgery due to a recurrence of the hallux valgus or overcorrection into hallux varus. Conclusion Dynamic tightrope fixation is a simple surgical technique that effectively corrects the 1,2 IMA during hallux valgus surgery.https://doi.org/10.1177/22104917241280285
spellingShingle Samuel Ka-Kin Ling
Jojo Hoi-Ching Lai
Esther Man-Wai Chow
Lucci Lugee Liyeung
Arthur On-Fai Woo
Patrick Shu-Hang Yung
Dynamic tightrope fixation for the correction of the 1,2 intermetatarsal angle in hallux valgus surgery
Journal of Orthopaedics, Trauma and Rehabilitation
title Dynamic tightrope fixation for the correction of the 1,2 intermetatarsal angle in hallux valgus surgery
title_full Dynamic tightrope fixation for the correction of the 1,2 intermetatarsal angle in hallux valgus surgery
title_fullStr Dynamic tightrope fixation for the correction of the 1,2 intermetatarsal angle in hallux valgus surgery
title_full_unstemmed Dynamic tightrope fixation for the correction of the 1,2 intermetatarsal angle in hallux valgus surgery
title_short Dynamic tightrope fixation for the correction of the 1,2 intermetatarsal angle in hallux valgus surgery
title_sort dynamic tightrope fixation for the correction of the 1 2 intermetatarsal angle in hallux valgus surgery
url https://doi.org/10.1177/22104917241280285
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